EP1781368A4 - Bis closed loop anesthetic delivery - Google Patents
Bis closed loop anesthetic deliveryInfo
- Publication number
- EP1781368A4 EP1781368A4 EP05767507A EP05767507A EP1781368A4 EP 1781368 A4 EP1781368 A4 EP 1781368A4 EP 05767507 A EP05767507 A EP 05767507A EP 05767507 A EP05767507 A EP 05767507A EP 1781368 A4 EP1781368 A4 EP 1781368A4
- Authority
- EP
- European Patent Office
- Prior art keywords
- patient
- anesthesia
- index
- depth
- drug
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Ceased
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
- A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
- A61M5/172—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic
- A61M5/1723—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic using feedback of body parameters, e.g. blood-sugar, pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4821—Determining level or depth of anaesthesia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4836—Diagnosis combined with treatment in closed-loop systems or methods
- A61B5/4839—Diagnosis combined with treatment in closed-loop systems or methods combined with drug delivery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/486—Bio-feedback
Definitions
- the present invention relates to sedation drug delivery and, more particularly, closed- loop sedation drug delivery.
- anesthesia refers to the continuum of hypnosis and analgesia achieved via sedation drugs, and ranges from anxiolysis to general anesthesia.
- sedation drug refers to the class of drugs employed by anesthesiologists in inducing sedation or anesthesia, and includes hypnotics, analgesics and the like.
- Bispectral Index is a continuously processed EEG parameter that measures the state of brain function during administration of sedation drags, as the measure of depth of anesthesia.
- BIS is a quantitative EEG analysis technique that has been developed for use during anesthesia.
- Bispectral analysis of EEG measures consistency of phase and power relationships among the various frequencies of the EEG. The index is derived from both a power spectral analysis and a time domain analysis.
- BIS provides decent population sedation and anesthesia values, there is significant patient-to-patient variability.
- the BIS index is a number between 0 and 100 scaled to correlate with important clinical end points during administration of sedation drags. A value of 100 represents an awake clinical state while 0 denotes an
- END5039WO isoelectric EEG.
- BIS values are inversely proportional to the plasma level of concentration of drugs in the patient, i.e. the lower the BIS value, the higher the concentration of drugs in the patient and the higher the BIS value, the lesser the concentration of drugs in the patient; however, each BIS spectrum varies significantly from patient to patient.
- the use of a model BIS spectrum to assess the depth of anesthesia is not reliable in individual patients. Accordingly, there is a need to tune BIS to each patient individually in order to correlate and assess the depth of anesthesia of the patient and thereby "close the loop" on the sedation drug delivery system.
- a first embodiment of the present invention provides a method for delivering a sedation drug comprising the steps of: administering a sedation drug to a patient while requesting the patient to respond to an instruction; monitoring a patient's BIS values; bringing the patient to a level of anesthesia where the patient fails to respond or slowly responds to the request; determining a BIS value that coincides with the level of anesthesia at which the patient fails to respond or slowly responds to the request; and establishing a BIS setpoint. Closed-loop delivery of the sedation drug is initiated to maintain the patient's BIS value at the setpoint.
- a second embodiment of the present invention provides a drug delivery apparatus having an automated response monitoring system (ARM), a Bispectral Index (BIS) monitoring apparatus to monitor a patient's BIS values during delivery of a sedation drug, and a sedation drug infusion device.
- ARM automated response monitoring system
- BIOS Bispectral Index
- FIG. 1 is a block diagram showing a sedation drug delivery system in accordance with one embodiment of the present invention
- FIG. 2 is a flow chart showing one method in accordance with the present invention.
- FIG. 3 is a diagram of an automated response monitoring (ARM) system.
- One embodiment of the present invention provides a closed-loop sedation drug delivery system by combining the features of BIS with the patient specific features of an Automated Response Monitoring system (ARM) to calibrate a set point and thereby "close-the-loop" on sedation drug delivery.
- ARM Automated Response Monitoring system
- other systems for indexing of depth of anesthesia may be substituted for BIS according to the present
- END5039WO invention such as, for example, Narcotrend and various audio evoked potential (AEP) devices.
- ARM by itself is a binary measure of responsiveness (i.e. the patient either responds or does not respond). ARM can play an integral role in a sedation drug delivery system by identifying the transition from moderate to deep sedation. However, since it is a binary measure it cannot provide adequate information regarding the patient's depth of anesthesia following loss of responsiveness. Because the patient loses responsiveness, ARM alone cannot be used to provide a closed loop sedation drug delivery system. Nevertheless, ARM can be used in conjunction with BIS (or other indices of depth of anesthesia) to efficiently determine the patient's level of anesthesia and "close-the-loop" on sedation.
- BIS or other indices of depth of anesthesia
- BIS has been used to measure changes in the effects of sedation drugs, such as anesthetics and the like, on the brain and, more specifically, the hypnotic state of the patient.
- BIS monitors are available commercially from Aspect Medical Systems, 141 Needham St., Newton, MA 02464. When a patient is more sedated, BIS values are lower and when a patient is less sedated, BIS values are higher. A patient's BIS values reflect the patient's reaction to a drug. A more sensitive patient will display a greater decrease in BIS values than a less sensitive patient when administered the same dosage of a drug.
- BIS can measure a patient's relative sedation level; however, the wide variability of patient sensitivity to drugs, even among patients having similar physical attributes, precludes the use of BIS alone to determine a patient's level of anesthesia.
- BIS should be correlated with the individual patient to determine the patient's level of anesthesia. This can be achieved by correlating the patient's responses to ARM with the patient's individual BIS values to more precisely determine the patient's level of anesthesia and further, to help establish a set-point or target level of anesthesia for the patient.
- ARM is a patient response system that sends various requests to a patient to receive a patient's response and then analyzes the patient's responses to the requests. By analyzing the patient's responses, the patient's level of anesthesia can be determined. The patient may also reach a level of anesthesia where the patient is no longer responsive to ARM or the patient fails to respond within a predetermined period of time. Several different criteria may be used in determining the end point when a patient is considered to have lost responsiveness to ARM.
- loss of ARM may occur when a patient fails to respond within a certain period of time after a request has been sent to the patient. Loss of ARM may also occur when the patient's response does not meet a minimum threshold response level.
- the clinician may determine the point at which the patient loses responsiveness to ARM. Although the criteria for what determines loss of ARM could be chosen by the clinician, the point at which the patient is deemed to have lost responsiveness to ARM is always correlated to the patient's BIS values for that specific point. By doing so, BIS values are correlated to the individual patient.
- Fig. 1 is a block diagram of a sedation drug delivery system 10 in accordance with one embodiment of the present invention.
- the system 10 includes a BIS monitor 12, a controller 14, an ARM system 16 and an infusion device 18.
- the infusion device 18 can be an automated infusion pump that is controlled via the controller 14.
- controller includes a single logic device that performs the disclosed function as well as any combination of logic devices that perform the disclosed functions.
- the controller 14 evaluates the output from the BIS monitor 12 and instructs the infusion device 18 to continue to deliver the sedation drug based on the output from the BIS monitor 12 and its relationship to a BIS setpoint established via the ARM system 16.
- a method in accordance with one embodiment of the present invention is diagrammed as a flow chart in Fig. 2.
- the clinician initializes the system by programming the controller 14 with information relevant to the patient, such as name, age and weight, etc. Based upon the input, the controller 14 will select or calculate an infusion modality or rate for the patient or the clinician can set a drug infusion rate.
- the controller 14 establishes the infusion rate based on a loading dose is described in commonly assigned U.S. Patent App. Ser. No. entitled "Dosage Control For Drug
- the infusion device 18 starts delivering the identification infusion rate and the controller 14 signals the BIS monitor 12 to begin monitoring the BIS index for the patient in step 24 and also signals the ARM system 16 to begin requesting responses from the patient in step 22.
- the ARM system mom ' tors the patient for responses to its requests.
- the device stays in an "open-loop," delivering the selected identification infusion rate and monitoring BIS and ARM, until the patient loses ARM response by either failing to respond to a predetermined number of requests (e.g., 1 to 3), or failing to respond within a predetermined response time (e.g., a predetermined number of seconds).
- the ARM system then signals the controller 14 of the loss of responsiveness to ARM and the device switches to "closed-loop" mode, adjusting the infusion rate, in an attempt to minimize the error (i.e., the difference between the Setpoint and the measured BIS value).
- closed-loop mode various known closed-loop algorithms may be used.
- the controller 14 receives BIS values from the BIS monitor 12 and uses the patient's BIS index at that point where responsiveness to ARM was lost as a setpoint (see step 27) based upon which the controller 14 monitors further drug infusion in step 28.
- the setpoint may not be based on the BIS index at that point itself but, depending upon the nature of the surgical procedure, may be based on a BIS value that is offset from it. For example, if the procedure is one that does not require deep anesthesia, the setpoint may be set several points higher than the point at which the patient lost
- the setpoint may be set several points lower than the point at which the patient lost response to ARM.
- the controller 14 With the BIS setpoint established, the controller 14 generates an error between the output from the BIS monitor 12 and the BIS setpoint (see step 28). The error is then minimized in step 30 using a closed-loop algorithm.
- the action of the closed-loop algorithm may depend on the sedation drug, the nature of the procedure, and the patient's characteristics. For example, if the patient's BIS index is substantially greater than the setpoint, the controller may increase the infusion rate. On the other hand, if the patient's BIS is substantially less than the setpoint, the controller may stop (or slow) the drug infusion.
- the invention also is not limited to infusion rate control based solely upon BIS monitoring but rather is open to systems in which either the BIS index comparison or the response to ARM or both are used.
- Figure 3 illustrates a conscious sedation system 100 including a controller 102 and a response testing apparatus 104.
- the controller 102 generates a request for a predetermined response from a patient 106 and analyzes at least a response generated by the patient 106 to the request to determine a level of sedation of the patient 106.
- the response testing apparatus 104 includes a request assembly 108 and a response assembly 110.
- the request assembly 108 communicates to the patient 106 the request generated by the controller 102.
- the response assembly 110 is used by the patient 106 to generate the response and communicates the response to the controller 102. Examples of response assemblies particularly useful herein are hand grip assemblies as described in detail in commonly assigned U.S. Patent App. Ser.
- the response assembly includes a handpiece which senses a dynamic variable of a hand grip response made by the patient to the request and communicates the dynamic variable to the controller which analyzes at least the dynamic variable to determine a level of anesthesia of the patient.
- the method of using ARM comprises applying a stimuli or request for a predetermined response to the patient; instructing the patient to respond to the stimuli; monitoring the patient's response to the stimuli; and repeating the steps until patient loses responsiveness to ARM.
- the patient's individual BIS values associated with the patient's level of anesthesia are also monitored.
- the BIS value at which the patient loses responsiveness to ARM is recorded and used to calibrate BIS to the individual patient.
- the BIS value at which the patient loses responsiveness to ARM is used as the BIS setpoint at which to maintain the patient's level of anesthesia. Nevertheless, the patient's BIS setpoint may be increased or decreased according to the physician's discretion.
- the setpoint specified by the anesthetist or other health care professional is preferably approached and maintained as closely as possible during the maintenance of the anesthesia.
- the BIS can be tuned to the individual patient, and set values can be established thereby closing the loop on the sedation drug delivery system.
- a drug is administered to the patient until loss of ARM.
- This may be accomplished by gradually increasing the infusion rate.
- the system gradually increases the drug infusion rate, starting at 50 ⁇ g/kg/min and stepping up the rate 25 ⁇ g/kg/min every 60 seconds until the patient loses responsiveness to ARM over three consecutive samples (i.e., the patient fails to respond to three consecutive ARM requests).
- the average BIS value over the three consecutive samples is used as the setpoint for the closed-loop controller.
- This BIS value (i.e., the BIS setpoint) corresponds to the target level of anesthesia at which the patient should be maintained during the procedure.
- the infusion rate may be operated with various profiles in bringing the patient to loss of ARM.
- different end points can be used to define the loss of ARM depending upon the age, health, and other characteristics of the patient. For example,
- the infusion pump can increase infusion rate at a constant rate or a constant slope ramp. It could also be a variable slope ramp or start high and have a negative slope ramp as long as the patient is taken to loss of ARM safely and quickly, preferably within five minutes.
- a BIS setpoint is established and the sedation drug delivery system maintains the desired level of anesthesia at the BIS setpoint for the remainder of the procedure. If the clinician wants a different level of anesthesia later in the procedure, he can accomplish this by changing the BIS setpoint value. For example, if the clinician wants a deeper level of anesthesia for a more sensitive aspect of the procedure, the clinician may lower the BIS set point.
- the user will be adjusting a BIS value that has been tuned to the specific patient via ARM. Accordingly, the clinician can close the loop on the sedation drug delivery system through this integration of the patient's response to ARM and the patient's BIS values.
- ARM alone, it was not possible to determine the patient's depth of anesthesia, however, by keeping the patient's level of anesthesia at or near the BIS value at which the patient lost responsiveness to ARM, over-sedation is prevented.
- a second embodiment of the present invention provides a drug delivery apparatus having an automated response monitoring system (ARM), a Bispectral Index (BIS) monitoring apparatus to monitor a patient's BIS values during delivery of a sedation drug, and a sedation drug infusion device.
- ARM automated response monitoring system
- BIOS Bispectral Index
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Pathology (AREA)
- Physics & Mathematics (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Biophysics (AREA)
- Anesthesiology (AREA)
- Diabetes (AREA)
- Vascular Medicine (AREA)
- Hematology (AREA)
- Biodiversity & Conservation Biology (AREA)
- Chemical & Material Sciences (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Medicinal Chemistry (AREA)
- Pharmacology & Pharmacy (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
- Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
- Measuring And Recording Apparatus For Diagnosis (AREA)
- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/886,322 US20060009733A1 (en) | 2004-07-07 | 2004-07-07 | Bis closed loop anesthetic delivery |
PCT/US2005/020316 WO2006016953A2 (en) | 2004-07-07 | 2005-06-09 | Bis closed loop anesthetic delivery |
Publications (2)
Publication Number | Publication Date |
---|---|
EP1781368A2 EP1781368A2 (en) | 2007-05-09 |
EP1781368A4 true EP1781368A4 (en) | 2009-06-10 |
Family
ID=35542333
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP05767507A Ceased EP1781368A4 (en) | 2004-07-07 | 2005-06-09 | Bis closed loop anesthetic delivery |
Country Status (9)
Country | Link |
---|---|
US (3) | US20060009733A1 (en) |
EP (1) | EP1781368A4 (en) |
JP (1) | JP4980215B2 (en) |
CN (2) | CN101026992A (en) |
AU (1) | AU2005272123B2 (en) |
CA (1) | CA2572945C (en) |
NZ (1) | NZ552435A (en) |
TW (1) | TWI465269B (en) |
WO (1) | WO2006016953A2 (en) |
Families Citing this family (23)
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US20060042634A1 (en) * | 2004-08-31 | 2006-03-02 | Nalagatla Anil K | Device for connecting a cannula to a medical effector system |
EP1832993B1 (en) * | 2006-03-06 | 2009-02-25 | General Electric Company | Automatic calibration of the sensitivity of a subject to a drug |
DE102007023246B3 (en) * | 2007-05-18 | 2008-04-03 | Dräger Medical AG & Co. KG | Device for supplying a patient with anesthetic gas comprises a unit for hypoventilating the patient and a unit for monitoring the spontaneous breathing of the patient during hypoventilation |
US8108039B2 (en) * | 2007-07-13 | 2012-01-31 | Neuro Wave Systems Inc. | Method and system for acquiring biosignals in the presence of HF interference |
US20090124867A1 (en) * | 2007-11-13 | 2009-05-14 | Hirsh Robert A | Method and device to administer anesthetic and or vosactive agents according to non-invasively monitored cardiac and or neurological parameters |
FR2940912B1 (en) | 2009-01-15 | 2013-08-16 | Hopital Foch | SYSTEM FOR CONTROLLING MEANS FOR INJECTING AGENTS OF ANESTHESIA OR SEDATION IN ORDER TO INDUCE THEM |
FR2940913B1 (en) * | 2009-01-15 | 2013-07-19 | Hopital Foch | SYSTEM FOR CONTROLLING INJECTION MEANS OF ANESTHESIA OR SEDATION AGENTS |
MX2013012933A (en) | 2011-05-06 | 2014-02-27 | Gen Hospital Corp | System and method for tracking brain states during administration of anesthesia. |
US11786132B2 (en) | 2011-05-06 | 2023-10-17 | The General Hospital Corporation | Systems and methods for predicting arousal to consciousness during general anesthesia and sedation |
US9092559B2 (en) | 2011-08-16 | 2015-07-28 | Ethicon Endo-Surgery, Inc. | Drug delivery system with open architectural framework |
US11565042B1 (en) * | 2012-08-08 | 2023-01-31 | Neurowave Systems Inc. | Anesthesia and/or sedation system and method |
CN103432651B (en) * | 2012-12-31 | 2016-01-20 | 南京理工大学 | A kind of intelligent anesthesia control system of closed loop |
CN103212119B (en) * | 2013-04-09 | 2015-11-18 | 陕西君天行机电科技有限公司 | A kind of anesthesia target controlled infusion pump controller based on BIS feedback |
ES2877551T3 (en) | 2013-04-24 | 2021-11-17 | Fresenius Kabi Deutschland Gmbh | Operating procedure of a control device to control an infusion device |
US10383574B2 (en) * | 2013-06-28 | 2019-08-20 | The General Hospital Corporation | Systems and methods to infer brain state during burst suppression |
CN203749411U (en) * | 2013-12-05 | 2014-08-06 | 北京思路高医疗科技有限公司 | Closed-loop control injection pump device for electroencephalogram monitoring sedation depth |
CN104189983A (en) * | 2014-09-23 | 2014-12-10 | 深圳市安保科技有限公司 | Deep sedation closed-loop control method and system |
US11116897B2 (en) * | 2016-04-18 | 2021-09-14 | The University Of British Columbia | Systems and methods for controlled delivery of analgesic and hypnotic agents |
CN109069736B (en) * | 2016-05-02 | 2022-03-01 | 费森尤斯维尔公司 | Control device for controlling administration of propofol to a patient |
CN107559228B (en) * | 2017-08-08 | 2019-11-26 | 浙江上风高科专风实业有限公司 | Method based on bispectral data detection and diagnosis fan trouble |
JP2022108079A (en) | 2021-01-12 | 2022-07-25 | 日本光電工業株式会社 | Biological information processing device, biological information processing method, program, and recording medium |
WO2022208120A1 (en) | 2021-03-30 | 2022-10-06 | Ruiz Nolasco Cristina | A system for non-invasive monitoring of nociception and consciousness levels of sedated and anesthetized patients |
CN115270524B (en) * | 2022-09-27 | 2023-01-17 | 天津天堰科技股份有限公司 | Method for simulating BIS |
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US5069688A (en) * | 1986-11-06 | 1991-12-03 | The Haser Company Limited | Pressure swing gas separation |
US5069668A (en) * | 1990-07-12 | 1991-12-03 | Boydman Scott A | Patient controlled analgesia system |
US5807316A (en) * | 1991-12-06 | 1998-09-15 | Teeple, Jr.; Edward | Method and apparatus for preparing and administering intravenous anesthesia infusions |
US5775330A (en) * | 1996-07-22 | 1998-07-07 | Battelle Memorial Institute | Neurometric assessment of intraoperative anesthetic |
US6016444A (en) * | 1997-12-10 | 2000-01-18 | New York University | Automatic control of anesthesia using quantitative EEG |
US7565905B2 (en) * | 1998-06-03 | 2009-07-28 | Scott Laboratories, Inc. | Apparatuses and methods for automatically assessing and monitoring a patient's responsiveness |
AU750050B2 (en) * | 1998-06-03 | 2002-07-11 | Scott Laboratories, Inc. | Apparatus and method for providing a conscious patient relief from pain and anxiety associated with medical or surgical procedures |
US6631291B2 (en) * | 2001-05-18 | 2003-10-07 | Instrumentarium Corp. | Closed loop drug administration method and apparatus using EEG complexity for control purposes |
CA2455978C (en) * | 2001-07-31 | 2008-09-09 | Scott Laboratories, Inc. | Apparatuses and methods for titrating drug delivery |
JP4593108B2 (en) * | 2001-11-01 | 2010-12-08 | スコット・ラボラトリーズ・インコーポレイテッド | User interface for sedation and analgesia delivery system |
US6944638B1 (en) * | 2001-11-14 | 2005-09-13 | Katharine T. Putnam | Medication dosage calculator |
US20050070823A1 (en) * | 2003-09-29 | 2005-03-31 | Donofrio William T. | Response testing for conscious sedation involving hand grip dynamics |
US20060009734A1 (en) * | 2004-07-07 | 2006-01-12 | Martin James F | Dosage control for drug delivery system |
-
2004
- 2004-07-07 US US10/886,322 patent/US20060009733A1/en not_active Abandoned
-
2005
- 2005-06-09 JP JP2007520312A patent/JP4980215B2/en not_active Expired - Fee Related
- 2005-06-09 CA CA2572945A patent/CA2572945C/en not_active Expired - Fee Related
- 2005-06-09 WO PCT/US2005/020316 patent/WO2006016953A2/en active Application Filing
- 2005-06-09 EP EP05767507A patent/EP1781368A4/en not_active Ceased
- 2005-06-09 CN CNA2005800272503A patent/CN101026992A/en active Pending
- 2005-06-09 CN CN2011102772525A patent/CN102488940A/en active Pending
- 2005-06-09 NZ NZ552435A patent/NZ552435A/en not_active IP Right Cessation
- 2005-06-09 AU AU2005272123A patent/AU2005272123B2/en not_active Ceased
- 2005-07-06 TW TW094122769A patent/TWI465269B/en not_active IP Right Cessation
-
2009
- 2009-01-07 US US12/349,872 patent/US20090118697A1/en not_active Abandoned
-
2016
- 2016-02-26 US US15/054,658 patent/US20160175522A1/en not_active Abandoned
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Title |
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DOUFAS A G ET AL: "Automated responsiveness test (ART) predicts loss of consciousness and adverse physiologic responses during propofol conscious sedation.", ANESTHESIOLOGY APR 2001, vol. 94, no. 4, April 2001 (2001-04-01), pages 585 - 592, XP002525319, ISSN: 0003-3022 * |
LESLIE K ET AL: "Closed loop control of sedation for colonoscopy using the Bispectral Index", ANAESTHESIA 2002 GB, vol. 57, no. 7, 2002, pages 693 - 697, XP002525318, ISSN: 0003-2409 * |
Also Published As
Publication number | Publication date |
---|---|
NZ552435A (en) | 2010-11-26 |
US20160175522A1 (en) | 2016-06-23 |
JP2008505693A (en) | 2008-02-28 |
TWI465269B (en) | 2014-12-21 |
AU2005272123B2 (en) | 2011-06-09 |
CA2572945C (en) | 2013-05-14 |
JP4980215B2 (en) | 2012-07-18 |
US20090118697A1 (en) | 2009-05-07 |
WO2006016953A2 (en) | 2006-02-16 |
US20060009733A1 (en) | 2006-01-12 |
WO2006016953A3 (en) | 2007-04-05 |
TW200613020A (en) | 2006-05-01 |
CA2572945A1 (en) | 2006-02-16 |
CN101026992A (en) | 2007-08-29 |
CN102488940A (en) | 2012-06-13 |
EP1781368A2 (en) | 2007-05-09 |
AU2005272123A1 (en) | 2006-02-16 |
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